An evaluation of the apprehension, relocation, and surprise tests for anterior shoulder instability
An evaluation of the apprehension, relocation, and surprise tests for anterior shoulder instability
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DOI：
10.1177/0095399703258690
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发表时间：
2004-03-01
影响因子：
4.8
通讯作者：
Kirkley, A
中科院分区：
文献类型：
--
作者：
Lo, IKY;Nonweiler, B;Kirkley, A
背景：尽管有许多研究描述了肩关节不稳定的检测，但很少有研究评估这些检测在诊断肩关节前路不稳定方面的有效性。目的：评估忧虑、移位和意外试验作为前肩不稳预测指标的有效性。研究设计：对前瞻性收集的资料进行回顾性分析。方法：46例明确诊断为以下肩部疾病之一的患者通过四个独立的盲法检查：外伤性前路不稳定（18例），肩袖肌腱病（17例），后路不稳定（2例），肩关节骨性关节炎（4例），或多向不稳定（5例）。还确定了观察者之间的信度。结果：在三项测试均有忧虑感的受试者中，阳性和阴性的平均预测值分别为93.6%和71.9%。惊喜试验是最准确的单一试验（灵敏度= 63.89%，特异性= 98.91%）。重新定位测试对忧虑感或疼痛感的改善并没有增加测试的价值。观察者间信度为0.83。结论和临床意义：本研究的结果表明，三项不稳定性检查均为阳性，可高度特异性地预测外伤性肱骨前关节不稳定性。
Background: Although there are many studies describing tests for shoulder instability, there are few assessing the validity of these tests in diagnosing anterior shoulder instability.Purpose: To assess the validity of the apprehension, relocation, and surprise tests as predictors of anterior shoulder instability.Study Design: Retrospective review of prospectively collected data.Methods: Forty-six patients with a clear diagnosis of one of the following shoulder disorders were evaluated by four independent, blinded examiners: traumatic anterior instability (18), rotator cuff tendinosis (17), posterior instability (2), glenohumeral osteoarthritis (4), or multidirectional instability (5). Interobserver reliability was also determined.Results: In subjects who had a feeling of apprehension on all three tests, the mean positive and negative predictive values were 93.6% and 71.9%, respectively. The surprise test was the single most accurate test (sensitivity = 63.89%; specificity = 98.91%). An improvement in the feeling of apprehension or pain with the relocation test added little to the value of the tests. Interobserver reliability was determined to be 0.83.Conclusions and Clinical Relevance: The results of this study suggest that a positive instability exam on all three tests is highly specific and predictive of traumatic anterior glenohumeral instability.